Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition that affects millions of people worldwide. While it’s most commonly associated with symptoms like shortness of breath, coughing, and fatigue, chest pain is another symptom experienced by a significant number of patients—nearly 45% of people with COPD report it.
Lesley Williams, a Registered Respiratory Therapist at Apria with 35 years of experience, states, “Chest pain in COPD is more than a symptom—it’s a signal. Understanding its causes and responding with the right care strategies is essential for improving comfort, preventing complications, and supporting long-term respiratory health.”
However, chest pain in COPD can arise from a variety of causes, some directly related to the condition, and others stemming from associated complications or entirely different health issues. Understanding the potential sources of this pain and knowing when to seek help is crucial for effective management and peace of mind.
Chest pain isn’t always a straightforward symptom of COPD. Here are several underlying reasons why it may occur:
When the muscles surrounding your airways tighten, it can cause bronchial spasms, leading to difficulty breathing and a tight, painful sensation in the chest.
People with COPD are more likely to develop gastroesophageal reflux disease (GERD). Overinflated lungs can compress parts of the digestive system, increasing reflux symptoms like heartburn and chest discomfort.
Inflammation from COPD may cause scar tissue to form between the lung’s protective membrane layers (pleura). This buildup can interfere with breathing movements and cause pain.
Overinflated lungs can also stretch the pleural membranes beyond their normal range, activating pain receptors and leading to discomfort.
Frequent or severe coughing can cause muscle strain in the chest and back, resulting in soreness or pain during movement or deep breathing.
COPD patients have a higher risk of developing pulmonary embolisms (PE) due to reduced mobility, increased red blood cell counts, and systemic inflammation. A PE can cause sharp, sudden chest pain, shortness of breath, and should be treated as a medical emergency.
Chest pain in COPD patients may also result from comorbid conditions, such as heart disease. A 2019 review found that 4 out of 5 COPD patients have another health condition that could contribute to chest pain.
The first step in managing chest pain is to understand its source. If you experience sudden or severe chest pain, or if accompanied by shortness of breath or dizziness, seek immediate medical attention. For mild to moderate discomfort, here are strategies that may help:
Adjusting your body position, such as sitting in the tripod position (leaning forward with hands on knees), can help improve breathing and reduce chest tightness.
Standing or sitting upright supports your chest and airways, making breathing easier and reducing muscle strain.
Avoid triggers like spicy, fatty foods, caffeine, and alcohol to prevent acid reflux. Eat smaller meals and avoid lying down right after eating.
Eat slowly, skip chewing gum, and avoid drinking through straws to reduce bloating and trapped air, which can press against the diaphragm and cause discomfort.
Deep breathing exercises, such as pursed-lip breathing, help strengthen respiratory muscles and improve oxygen intake. Inhale slowly through your nose and exhale even more slowly through pursed lips.
Applying a cold compress to sore areas can help reduce inflammation and muscle tension in the chest.
A warm compress or heating pad can relax tight chest muscles, relieve joint stiffness, and ease pain.
Gentle massage has been shown to reduce pain and stress in COPD patients, improving both physical and emotional comfort.
Engaging in light cardiovascular, stretching, or strength activities can help maintain respiratory function and reduce muscle stiffness. Consult a physical therapist for a tailored plan.
A 2016 study suggests acupuncture may help relieve shortness of breath and chronic pain in COPD patients.
COPD medications—such as bronchodilators or corticosteroids—can reduce inflammation, coughing, and chest tightness. If chest pain persists, your provider may explore additional treatment options, including pain management strategies.
Always consult a healthcare provider if your chest pain is new, worsening, or unexplained. It’s essential to distinguish between COPD-related discomfort and potentially serious conditions like heart issues or pulmonary embolism.
While chest pain can be common for people with COPD, it’s not always a direct result of the lung condition. Identifying the underlying cause is key to choosing the right treatment strategy. With proper management, including lifestyle adjustments, breathing techniques, and medical support, many patients can find relief and improve their quality of life. Learn more about Apria’s Respiratory Care program and how we can help.
References
Bordoni, Bruno, Fabiola Marelli, Bruno Morabito, and Roberto Castagna. “Chest Pain in Patients with COPD: The Fascia’s Subtle Silence.” International journal of chronic obstructive pulmonary disease, April 12, 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC5903840/.
Feng, Junfei, Xuehui Wang, Xing Li, Dejun Zhao, and Jinquan Xu. “Acupuncture for Chronic Obstructive Pulmonary Disease (COPD).” U.S. National Library of Medicine, October 2016. https://pmc.ncbi.nlm.nih.gov/articles/PMC5059044/.
“Heartburn and Acid Reflux.” NHS choices, November 20, 2023. https://www.nhs.uk/conditions/heartburn-and-acid-reflux/.
“How Can I Manage My Breathlessness?” Asthma + Lung UK, March 31, 2024. https://www.asthmaandlung.org.uk/symptoms-tests-treatments/symptoms/breathlessness/how-can-i-manage-my-breathlessness.
Werner, Carly. “COPD and Chest Pain: The Link and Tips to Manage.” Edited by Adithya Cattamanchi. Healthline, February 8, 2024. https://www.healthline.com/health/copd/copd-and-chest-pain.
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